Pediatric emergency care
-
Pediatric emergency care · Jan 2022
Case ReportsAirway Obstruction from a Tracheal Mass in a 5-Year-Old: A Case Report.
Stridor is a common presenting symptom for children in emergency departments (EDs) and usually represents an infectious process, such as croup, or aspiration of a foreign body. We present the case of an otherwise healthy 5-year-old girl with episodic increased work of breathing for several months that was initially diagnosed as asthma by her primary care physician. She subsequently presented to the ED with acutely worsening noisy breathing and dyspnea. ⋯ The mass was partially resected, resolving all of her respiratory symptoms. Although primary airway tumors in children are rare, they must be considered on the differential diagnosis of new noisy breathing or respiratory distress. Failure to diagnose these tumors in a timely manner can be life-threatening.
-
Pediatric emergency care · Jan 2022
Radiation-Free Diagnosis of Pediatric Appendicitis: Accuracy of Point-of-Care Ultrasonography and Magnetic Resonance Imaging.
Appendicitis is a common pediatric surgical emergency, and it can often be difficult to diagnose. Computed tomography is commonly used as a diagnostic criterion standard, but herein, we describe the accuracy of a "radiation-free" diagnostic algorithm using point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to diagnose pediatric appendicitis. ⋯ Using POCUS and MRI for the diagnosis of pediatric appendicitis is a highly accurate way to avoid ionizing radiation in children. In our study, POCUS is as accurate as MRI, although this is limited by being mostly done by a single provider and a high number of equivocal examinations.
-
Pediatric emergency care · Jan 2022
Poorly Controlled Pediatric Fracture Pain Requiring Unplanned Medical Assistance or Advice.
This study aimed to define the proportion of children who seek assistance for poorly controlled fracture pain, identify factors associated with requesting help, and explore caregivers' opioid preferences. ⋯ A notable proportion of children seek assistance for poorly controlled fracture-related pain. Medical providers should target discharge instructions to the identified risk factors and engage caregivers in shared decision making if opioids are recommended.
-
Pediatric emergency care · Jan 2022
Interhospital Transport of Children With Peripheral Venous Catheters by Private Vehicle: A Mixed Methods Assessment.
Many children seeking emergency care at community hospitals require transport to tertiary centers for definitive management. Interhospital transport via ambulance versus patient's own vehicle (POV) are 2 possible modes of transport; however, presence of a peripheral venous catheter (PIV) can determine transport by ambulance. Caregiver satisfaction, patient comfort, and PIV complications related to POV transport have not been described. ⋯ In select scenarios, interfacility transport by POV is preferred by families and doing so with a saline-locked PIV does not result in complications.
-
Pediatric emergency care · Jan 2022
Helmets Protect Pediatric Bicyclists From Head Injury and Do Not Increase Risk of Cervical Spine Injury.
Only 21 states have mandatory helmet laws for pediatric bicyclists. This study sought to determine the incidence of helmeted riders among pediatric bicyclists involved in a collision and hypothesized the risk of a serious head and cervical spine injuries to be higher in nonhelmeted bicyclists (NHBs) compared with helmeted bicyclists (HBs). ⋯ Pediatric bicyclists involved in a collision infrequently wear helmets, and NHBs was associated with higher risks of serious head injury. However, the associated risk of serious spine injury among NHBs was lower. The associated risks for cervical spine fracture or cervical cord injuries were similar. Nonhelmeted bicyclists were more likely to lack insurance and to be Black or Hispanic. Targeted outreach programs may help decrease the risk of injury, especially in at-risk demographics.